Imaging of ancient schwannoma

AJR Am J Roentgenol. 2004 Aug;183(2):331-6. doi: 10.2214/ajr.183.2.1830331.


Objective: We surveyed the clinical symptoms and radiologic features of ancient schwannoma, a rare variant of schwannoma characterized by degenerative changes.

Materials and methods: We present the clinical, radiologic, and pathologic features in seven patients with ancient schwannoma (mean age, 62 years; range, 45-80 years) treated at our department between 1998 and 2003.

Results: The most characteristic clinical features were a sign like Tinel's sign and a long interval between the onset of symptoms and surgery (mean interval, 8.3 years). Ancient schwannomas can grow large; the biggest tumor seen in our study was 14 cm long. The highly accurate radiologic assessment made possible with contrast-enhanced MRI and CT scanning showed enhancement at a peridegenerative area and sometimes at a capsule. These findings differ from those of the typical schwannoma and neurofibroma patterns reported to date. Furthermore, bone scintigraphy showed uptake in the tumor, but no accumulation was seen on gallium-67 citrate scintigraphy.

Conclusion: The characteristic clinical and radiologic findings of ancient schwannoma should make it possible to differentiate it from malignant tumors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurilemmoma / diagnosis*
  • Neurilemmoma / diagnostic imaging
  • Neurilemmoma / pathology
  • Soft Tissue Neoplasms / diagnosis*
  • Soft Tissue Neoplasms / diagnostic imaging
  • Soft Tissue Neoplasms / pathology
  • Tomography, X-Ray Computed